Hot Topics: Decision making
This post will appear as an editorial in a future issue of the American Journal of Bioethics
by Robert Klitzman, MD
While attention has focused in many states and countries on the initial acute phase of COVID-19 pandemic and on lowering rates of infection and deaths, evidence suggests that among many survivors, the virus is causing ongoing symptoms that need to be more fully anticipated and addressed.…Full Article
by R. Thomas Day, Bradley S. Guidry, Brian C. Drolet, Ellen W. Clayton
The United States has never experienced the grim realities of a resource-limited healthcare environment like that brought by Covid-19.…Full Article
by Thomas D. Harter, PhD, Mary E. Homan, DrPH, MA, MSHCE
COVID-19’s emergence in the US has once again thrust the field of bioethics in the public spotlight.…Full Article
by Asma Fazal, M.B.B.S, MRCPI, MHSc
To care for children in the neonatal intensive care unit (NICU) and the pediatric intensive care unit (PICU) is not easy because in addition to having an emotionally charged environment with high morbidity and mortality, it has a patient population who is not autonomous.…Full Article
by B. Corbett Walsh, MD, MBE; Anna Nolan, MD, MScFull Article
by Laura Specker Sullivan, Ph.D. and Dan Rosen, J.D.
As Fairchild et al. describe in a forthcoming issue of the American Journal of Bioethics, the American debate on social distancing regulations has pitted those protesting unacceptable state limitations on individual rights versus those demanding that individual rights to protection create a government obligation.
by Henri-Corto Stoeklé Ph.D., Asmahane Benmaziane M.D., Philippe Beuzeboc M.D., Christian Hervé, M.D., Ph.D.
In a letter published in The American Journal of Bioethics, we wrote “now really isn’t the time for ethical reflections” in the face of COVID-19.
by Joyeeta G Dastidar, MD
In New York City, the epicenter of the COVID-19 pandemic in the country with a quarter of the nation’s cases, hospitals prepared for ventilator shortages.
by Fernando Hellmann, Ph.D., Silvia Cardoso Bittencourt, Ph.D., Fabíola Stolf Brzozowski, Ph.D., Mirelle Finkler, Ph.D., Marta Verdi, Sandra Caponi, Ph.D.
by Jing Wan,Yuqiong Huang, Amaneh Abdel Hafez Aljaafreh, Dandan Dong, Yali Cong , Jun Lin, Hongxiang Chen
COVID-19 is an emerging infectious disease that is extremely contagious and can cause serious consequences and even death.
Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force
The COVID-19 Pandemic: Critical Care Allocated in Extremis
Ethical Dilemmas in Covid-19 Medical Care: Is a Problematic Triage Protocol Better or Worse than No Protocol at All?
Better Consent—and Not Just for When Time Is Short
Meaningful Fissures: The Value of Divergent Agendas in Patient Advocacy
When Thinking is Doing: Responsibility for BCI-Mediated Action
How Bioethics and Case Law Diverge in Assessments of Mental Capacity: An Argument for a Narrative Coherence Standard
Brain-Computer Interfaces and the Philosophy of Action
A Narrative Coherence Standard for the Evaluation of Decisional Capacity: Turning Back the Clock
The debate over plasma therapy continues on. Should its use become widespread? Although it has been authorized for use from the government, many hospitals grapple with this therapeutic due to need for further study.Full Article
“It’s still too soon to try to make genetically edited babies because the science isn’t advanced enough to ensure safety, says an international panel of experts who also mapped a pathway for any countries that want to consider it.”
Nearly two years after the world was shocked from news of the first gene-edited CRISPR babies in China, a panel of experts has reviewed and deemed that editing embryos is not ready scientifically. A further report on the ethics is to come later this year.
Policymakers increasingly consult value assessment models to help price new medical interventions. Value models use prespecified approaches and selected health outcomes to match the price of an intervention to its expected benefits. Who chooses the approach and outcomes, however, is at the center of a debate about the value of pharmaceutical, biotech, and medical device-based interventions.Full Article
The rewards of social distancing are beginning to accrue in former hotspots such as Seattle, the New York metropolitan area, and the San Francisco Bay Area, where the number of new Covid-19 cases requiring hospitalization is declining. Assuming the rewards hold in the face of pressures to reopen the economy, hospitals will now face challenges of reopening their own nonpandemic services for patients whose elective surgeries and other procedures were postponed. Which patients should get priority?Full Article
My patients needed procedures, but how long could they wait? Four weeks? Twelve?Full Article
One of the factors considered most important by dying patients and their families is the opportunity to be together. For many of our hospitalized patients in palliative care, the presence of loved ones at the bedside is such a given that we don’t even address it explicitly in advance care planning discussions. So, it comes as no surprise that Covid- 19-related visitor restrictions affecting hospitalized patients might impact end-of-life decision-making, potentially in ways that are ethically problematic.Full Article
The Covid-19 pandemic has been characterized by many unknowns, chief among them in the world of pediatric ethics is the question of separating mothers who are infected or suspected of being infected from their newborns after delivery to reduce the risk of mother-to-child transmission. Guidance on this issue is conflicting.Full Article
Imagine it is two weeks from now and you live in one of the dozens of cities—including Harrisburg—that have recently seen anti-lockdown protests. Your immunocompromised parent or child becomes sick with COVID, so you take them to the hospital because they cannot breathe. How will you feel when you find out that all of the hospital’s ventilators are being used by a cluster of individuals all of whom attended the same protest?Full Article
We are being told to do a lot of things these days: Wash your hands. Don’t touch your face. Wear a mask outside. Stock the house with two weeks of food. Dust off your will. And make sure to complete your advance directive and talk to the people who matter in your life about your wishes for end-of-life care.Full Article
After weeks of searching high and low for ventilators, New York Gov. Andrew Cuomo and health care leaders around the state have seen signs of improvement and are sending some of the frantically acquired units to New Jersey, where they’re increasingly needed. But now, many hospital workers on the front lines in the metro area have been sounding the alarm that a different piece of lifesaving equipment is in short supply and high demand: dialysis machines.Full Article